MEDICARE: WEST END PREMIER PHARMACY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1346682218
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST END PREMIER PHARMACY LLC

Provider Business Mailing Address
First Line	:	9319 FLORAL CREST DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77083-5080
Country	:	US
Telephone Number	:	832-236-7173
Fax Number	:

Provider Business Practice Location Address
First Line	:	2205 HIGHWAY 6 S
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-4321
Country	:	US
Telephone Number	:	832-243-2625
Fax Number	:	832-243-5386

Authorized Official
Title or Position	:	PHARMACIST
Name	:	DR. ANITA SHA-RON LEWIS
Credential	:
Telephone Number	:	832-236-7173

Provider Enumeration Date	:	07/21/2013
Last Update Date	:	07/21/2013

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Directions to “WEST END PREMIER PHARMACY LLC ” Practice Location

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